Awareness of Folic Acid Intake among Women in the Childbearing Age in Hail Region—Saudi Arabia


This study evaluated the awareness of folic acid, timing of folic acid supplementation and source of knowledge of folic acid intake in Hail region-Saudi Arabia. A sample of 300 married women in the childbearing age (19 - 45 years) in Hail in the period between October/2011 and January/2012 participated in a survey study regarding awareness and use of folic acid before and during pregnancy. Participant women were asked to respond to different questions related to age, level of education, occupation, monthly income, gravidity, and other information concerning folic acid awareness, specific knowledge, supplementation practices, and source of knowledge about the preconceptional intake of folic acid. While 91.0% of the subjects were aware of folic acid, 81.0% knew that folic acid could prevent neural tube defects and 84.0% of the subjects took folic acid prior or during a certain stage of pregnancy. Nonetheless, only 10.0% of the subjects who proclaimed that they know the proper timing for folic acid supplementation recognized that folic acid should be taken prior and during the first trimester of pregnancy. University education was the strongest predictor of folic acid knowledge and university educated subjects had significantly (P < 0.01) higher folic acid supplementation compared to subjects with lower educational level. Women with lower gravidity and those with planned pregnancies reported significantly (P < 0.05, and P < 0.01, respectively) higher folic acid supplementation. University education was the strongest predictor of folic acid knowledge. Health care providers were the main source of knowledge of folic acid education. It is recommended that health care professionals and media need to emphasize more on educating women about the importance of taking folic acid supplementation in the proper time.

Share and Cite:

M. Al-Holy, A. Eideh, S. Epuru, D. Abu-Jamous and I. Ashankyty, "Awareness of Folic Acid Intake among Women in the Childbearing Age in Hail Region—Saudi Arabia," Food and Nutrition Sciences, Vol. 4 No. 1, 2013, pp. 49-55. doi: 10.4236/fns.2013.41008.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] M. Karin, K. M. van der Pal-de Bruin, P. G. Heijden, S. E. Buitendijk and L. D. Ouden, “Periconceptional Folic Acid Use and the Prevalence of Neural Tube Defects in the Netherlands,” European Journal of Obstetrics, Gynecology and Reproductive Biology, Vol. 108, No. 1, 2003, pp. 33-39. doi:10.1016/S0301-2115(02)00362-7
[2] MRC Vitamin Study Research Group, “Prevention of Neural Tube Defects: Results of the Medical Research Council Vitamin Study,” Lancet, Vol. 338, No. 8760, 1991, pp. 131-137. doi:10.1016/0140-6736(91)90133-A
[3] Centers for Disease Control and Prevention, “Recommendations for the Use of Folic Acid to Reduce the Number of Cases of Spina Bi?da and Other Neural Tube Defects,” Morbidity and Mortality Weekly Report, Vol. 41, 1992, pp. 1-7.
[4] S. R. Rolfes, K. Pinna and E. N. Whitney, “Understanding Normal and Clinical Nutrition,” 6th Edition, Wadsworth, Belmont, 2009.
[5] G. P. Oakley, “Inertia on Folic Acid Forti?cation: Public Health Malpractice,” Teratology, Vol. 66, No. 1, 2002, pp. 44-54. doi:10.1002/tera.10079
[6] C. M. Cornel, D. J. de Smit and L. T. W. de Jong, “Folic Acid—The Scientific Debate as a Base for Public Health Policy,” Reproductive Toxicology, Vol. 20, No. 3, 2005, pp. 411-415. doi:10.1016/j.reprotox.2005.03.015
[7] A. M. Molloy, “The Role of Folic Acid in the Prevention of Neural Tube Defect,” Trends in Food Science and Technology, Vol. 16, No. 6-7, 2005, pp. 241-245. doi:10.1016/j.tifs.2005.03.009
[8] R. J. Berry, Z. Li, J. D. Erickson, S. Li, C. A. Moore and H. Wang, et al, “Prevention of Neural-Tube Defects with Folic Acid in China. China-US Collaborative Project for Neural Tube Defect Prevention,” New England Journal of Medicine, Vol. 341, 1999, pp. 1485-1490. doi:10.1056/NEJM199911113412001
[9] O. Y. Safdar, A. A. Al-Dabbagh, W. Abuelieneen and J. A. Kari, “Decline in the Incidence of Neural Tube Defects after the National Fortification of Flour (1997-2005),” Saudi Medical Journal, Vol. 28, No. 8, 2007, pp. 1227-1229.
[10] M. D. Al-Mendalawi and J. A. Kari, “Folic Acid Awareness among Female College Students. Neural Tube Defect Prevention,” Saudi Medical Journal, Vol. 30, No. 5, pp. 723-724.
[11] A. Asindi and A. Al-Shehri, “Neural tube defects in the Asir region of Saudi Arabia,” Annals of Saudi Medicine, Vol. 21, No. 1-2, pp. 26-29.
[12] J. A. Kari, E. S. Bardisi, R. M. Baitalmal and G. A. Ageely, “Folic Acid Awareness among Female College Students: Neural Tube Defects Prevention,” Saudi Medical Journal, Vol. 29, 2008, pp. 1749-1751.
[13] A. A. Mansour and S.A. Hassan, “Factors that Influence Women’s Nutrition Knowledge in Saudi Arabia,” Health Care for Women International, Vol. 15, No. 3, 1994, pp. 213-223.
[14] D. C. Wilton and M. J. Foureur, “A Survey of Folic Acid Use in Primigravid Women,” Women and Birth, Vol. 23, No. 2, 2010, pp. 67-73. doi:10.1016/j.wombi.2009.09.001
[15] M. A. Canfield, S. M. Przybyla, P. A. Case, T. Ramadhani, L. Suarez and J. Dryer, “Folic Acid Awareness and Supplementation among Texas Women of Childbearing Age,” Preventive Medicine, Vol. 43, No. 1, 2006. pp. 27-30. doi:10.1016/j.ypmed.2006.01.022
[16] D. Y. Wu, G. Brat, G. Milla and J. Kim, “Knowledge and Use of Folic Acid For Prevention of Birth Defects amongst Honduran Women,” Reproductive Toxicology, Vol. 23, No. 4, 2007, pp. 600-606. doi:10.1016/j.reprotox.2007.01.010
[17] P. N. Kirke, A. M. Molloy, L. E. Daly, H. Burke, D. G. Weir and J. M. Scott, “Maternal Plasma Folate and Vitamin B12 Are Independent Risk Factors for Neural Tube Defects,” The Quarterly Journal of Medicine, Vol. 86, 1993, pp. 703-708.
[18] L. E. Daly, P. N. Kirke, A. Molloy, D. G. Weir and J. M. Scott, “Folate Levels and Neural Tube Defects: Implications for Prevention,” Journal of American Medical Association, Vol. 274, No. 21, 1995, pp. 1698-1702. doi:10.1001/jama.1995.03530210052030
[19] T. W. Sadler, “Mechanisms of Neural Tube Closure and Defects,” Mental Retardation and Development, Vol. 4, No. 4, 1998, pp. 247-253. doi:10.1002/(SICI)1098-2779(1998)4:4<247::AID-MRDD3>3.0.CO;2-P
[20] A. Ren, L. Zhang, Z. Li, L. Hao, Y. Tian and Z. Li, “Awareness and Use of Folic Acid, and Blood Folate Concentrations among Pregnant Women in Northern China—An Area with a High Prevalence of Neural Tube Defects,” Reproductive Toxicology, Vol. 22, 2006, pp. 431-436.
[21] M. Felkner, L. Suarez, K. Hendricks and R. Larsen, “Implementation and Outcomes of Recommended Folic Acid Supplementation in Mexican-American Women with Prior Neural Tube Defect-Affected Pregnancies,” Preventive Medicine, Vol. 40, No. 6, 2005, pp. 867-871. doi:10.1016/j.ypmed.2004.10.006
[22] S. J. Thompson, M. E. Torres, R. E. Stevenson, J. H. Dean and R. G. Best, “Periconceptional Multivitamin Folic Acid Use, Dietary Folate, Total Folate and Risk of Neural Tube Defects in South Carolina,” Annals of Epidemiology, Vol. 13, No. 6, 2003, pp. 412-418. doi:10.1016/S1047-2797(02)00460-X
[23] J. G. Ray, C. V. Meier, M. J. Cermeulen, S. Boss, P. R. Wyatt and D. E. Cole, “Association of Neural Tube Defects and Folic Acid Food Fortification in Canada,” Lancet, Vol. 360, No. 9350, 2002, pp. 2047-2048. doi:10.1016/S0140-6736(02)11994-5
[24] R. S. Olney and J. Mulinare, “Trends in Neural Tube Defect Prevalence, Folic Acid Fortification, and Vitamin Supplement Use,” Seminars in Perinatology, Vol. 26, No. 4, 2002, pp. 277-285. doi:10.1053/sper.2002.34773
[25] G. P. Oakley, “Elimination of Folic Acid Preventable Neural Tube Defects,” American Journal of Preventive Medicine, Vol. 35, No. 6, 2008, pp. 606-607. doi:10.1016/j.amepre.2008.09.017

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.